Quickie QM-715 HD Group 3

Transcription

1 Quickie QM715 HD Grup 3 (K0850, K0858) EIPW11, Nvember 2012 Accunt: Ship T: Date: Name: PO#: Address: uyer: ity,state,zip: Marked Fr: Phne: The HPS ODES prvided are based n cde verificatin thrugh PDA r ur interpretatin f the cde definitins. The use f HPS ODES des nt ensure cverage r payment. Fr cverage infrmatin, verify the apprpriate payer's cverage plicy. a Optin # HPS Definitin Price a Optin # HPS Definitin Price 1. QUIKIE QM715 HD GROUP 3 ATEGORY (Select One) QUIKIE QM715 HD (Grup 3 K0850/K0011) Quickie QM715 HD w/ ASAP II Seat (Fig 1.1) 172P79 K0850 K0011 QUIKIE QM715 HD S (Grup 3 K0858/K0011) $6, Quickie QM715 HD S fr SPOT Tilt (Fig 1.2) 172P80 ase Package VR2 90A Drive ntrl (nnexpand) K0858 K lb 5 mph 4ple Mtr Package 172N88 K EQ19 172EQ18 VR2 90A Drive ntrl (nnexpand) 400 lb 5 mph 4ple Mtr Package ASAP II Rehab Seat Frame ASAP II Rehab Seat Frame 14" Drive Wheels (flat free insert ) 14" Drive Wheels (flat free insert ) 8A Dual Mde (mpact) TE 8A Dual Mde (mpact) TE QM715 HD ASE ONLY Fr use with Aftermarket Seat frame. $6, ase Package QM715 HD S ASE ONLY Fr use with Aftermarket Seat frame. $6, N89 K0858 QM715 HD SEAT ONLY w/ elect. Fr use t add/replace seating when additinal electrnics are nt required. 172EQ21 QM715 HD S SEAT ONLY w/ elect Fr use t add/replace seating when additinal electrnics are nt required. QM715 HD SEAT ONLY w/ elect. Fr use t add/replace seating when additinal electrnics are required. 172EQ20 QM715 HD S SEAT ONLY w/ elect. Fr use t add/replace seating when additinal electrnics are required. 1.1 QM715 HD 1.2 QM715 HD S ORDERING INFORMATION: PHONE: (800) FA: (800) rders@sunmed.cm WESITE: Specificatins are subject t change withut ntice. pyright REV Page 1 $6,695.00

2 2. ASE HAIR OPTIONS Speed Package 172PF84 Ventilatr Optins 400lbs / 5 mph 4 Ple Mtr (nt available w/ lb) 172VT7 E1030 Articulating Vent Tray 172VT4 E1029 Fixed Vent Tray (Pulmnetic LTV Mdels) $1, $ Shrud lr 172EZ01 andy Apple Red 172EZ02 High Glss lack 172FA EZ03 andy lue 172FA EZ04 Silver 172FA EZ05 pper 172FA EZ06 Digital am. $ EZ07 Wdland am. $ PreSet Seat Frame Angle () Nt available with Tilt Seat Height (Measured in the frnt) Obtain Qute t verify est. STFH User weight 172HT44 Lwest STFH 172WG lb 172HT45 +1" STFH 172WG lb 172HT46 +2" STFH 172WG lb 172HT47 +3" STFH STFH Matrix Drive Wheel 172DW37 14" ast Wheel Slid Inserts (Knbby) 172DW36 14" ast Wheel Pneumatics (Knbby) Seating Type and Pwer Optin mbinatins ASAP II N pwer seating. Wheel lcks ASAP II Tilt nly 172WL42 Wheel lcks SeattFlr Height at 0 tilt Lw +1" +2" +3" 17.3" 18.3" 19.3" 20.3" 18.6" 19.6" 20.6" 21.6" Adding seat angle will increase STFH by 1" fr each incremental change. Actual STFH may vary by.5" 3. ATTERIES and HARGERS atteries (Gel ells) attery harger 172AG04 E AG06 Grup 24 Flat Tp Gel ell (Pair) w/straps Omit batteries Includes harness & straps fr flat tp batteries $ J19 8A Dual Mde (mpact) TE 172J3 Omit harger ORDERING INFORMATION: PHONE: (800) FA: (800) rders@sunmed.cm WESITE: Specificatins are subject t change withut ntice. pyright REV Page 2 $40.00

3 4. ELETRONIS Drive ntrl Optins 172ER01 Switch Munt racket Nnexpandable cntrller RNet Expandable Drive ntrl Upgrade (90A) 172EM01 Single Switch Munt racket $ EM02 Dual tggle switch munt bracket 172EM03 4way tggle switch munt bracket. 172E01 E2377 Expandable ntrller Rnet $ E02 E2313 Harnessing fr Expandable ntrller $ VR2 Jystick (nnexpandable) 172J94 Nn Expandable VR2 Jystick Specialty Driver ntrl Optins Rnet Jystick (fr expandable electrnics) 172J70 Std LED Jystick fr Expandable trls 172J93 172J88 172J95 Jystick w/stere Jacks and Mnchrme Display Jystick W/Tggle, Spd Pt, Stere Jacks & lr Display $ Omit JS fr use with OMNI Requires expandable cntrls and OMNI. All packages must be added t the specialty cntrl nchair package. Nt available with Uphlstered backs. Jystick Munt (Fixed r Swing Away) 172JM10 172JM11 Fixed Munt Swing Away Munt $ Jystick Munt (Lcatin) Height Adjustable. Quickie Sip n' Puff System E2325 Sip N' Puff Kit 172II01 E0955 Headrest Headrest Remvable Munt 172IH1 E2326 Sip n' Puff Tubing and Hardware ASL Head Array Package (Adult) 172II02 ASL Prximity Head Array (Adult) Headrest Remvable Munt ASL Head Array Package (Ped) 172II03 ASL Prximity Head Array (Ped) Headrest Remvable Munt SwitchIt Head Array Package (Adult) 172HM1 Right Side Munt 172II04 Switchit Prximity Head Array 172HM2 Left Side Munt Headrest Remvable Munt Jystick Handle (Optinal) SwitchIt Head Array Package (Pediatric) 172II05 Switchit Prximity Head Array 172JH1 all Handle Headrest Remvable Munt 172JH2 Fam all Handle 172JH4 THandle ASL Prprtinal Mini Jystick hin / Lip ntrl Package 172JH6 Galpst Rnet OMNI and Output Optins (Fr expandable cntrls, chse all that apply) 172ON1 172ON2 E ON3 Rnet OMNI Input ntrl Mdule and display with built in Infrared and armrest munt. hse munt belw. (required fr Specialty Input Devices.) $ Rnet Output Mdule (EM) $ Rnet luetth Musemver $ $2, ID34 $1, $ $4, ID36 E2312 Mini Jystick 172II01 E0955 Headrest Headrest Remvable Munt ASL Prprtinal Mini Jystick Midline with Gatlin Package 172ID37 E2312 Mini jystick 172IJ03 ASL Prprtnal S/A Jystick Munt Quickie Prprtinal hin ntrl Package $4, $4, $4, $4, ID45 E2312 Prprtinal Jystick 172IJ03 ASL Prprtnal S/A Jystick Munt $4, OMNI Munt Attendant ntrl (If used with Jystick must be munted ppsite side) 172DS03 Swing Away Left Side OMNI Munt $ A01 E2331 Attendant ntrl fr VR2 $ DS04 Swing Away Right Side OMNI Munt $ A02 E2331 Attendant ntrl fr Rnet $ Switch inputs fr Jysticks r OMNI Attendant Munting lcatin Drive r Mde / Prfile ntrl 172DN1 Munting lcatin: Right ack ane 172DN2 Munting Lcatin: Left ack ane 172SW22 Stere t 2 Mn Splitter $ SW6 Ribbn Switch $ SW1 uddy uttn Switch 172SW2 Disc Switch $ PR2 VR2 Hand Held Prgrammer (HHP) $ SW9 Wbble Switch $ PR5 Rnet P Prgrammer with Dngle $ SW4 Micr Light Switch 172PR6 DTT VR2 and Rnet cables included. 172SW24 Egg Switchlack $ SW21 Dual tggle switch nly 172SW19 Penta Switch with D9 nnectr 172SW20 A5 5 Switch Adapter w/ D9 nnectr $ SW23 4way tggle switch w/5th buttn D9 nnectr. Electrnic Prgrammers ORDERING INFORMATION: PHONE: (800) FA: (800) rders@sunmed.cm WESITE: Specificatins are subject t change withut ntice. pyright REV Page 3 $1,000.00

4 5. SEAT TYPE 172ST56 Quickie A.S.A.P II (Adjustable Seating and Psitining) hse Seat Frame Size Platfrm. ASAP II Frame size (each frame is width and depth adjustable within given range. ) 172FU18 Adjustable 16x12 t 20x20 ( ) 172FU19 Adjustable 18x16 t 22x22 ( ) 6. SEAT SIZE Seat Size Matrix. Seat type is chsen in sectin 5. ASAP II Seat Width = ASAP II Seat Frame (Adjustable frm 1816 t 2222) Depth = ASAP II Seat Frame (Adjustable frm 1616 t 2020) 21" Seat Width Seat Depth 172R5 () 172RF5 () 172R6 () 172RF6 () 172R7 () 172RF7 () 172R8 () 172RF8 () 172R9 () 172RF24 () 172R25 () 172RF26 21" () 172RF25 () 7. SEAT USHIONS JAY ushins (Optinal) T rder any JAY cushins nchair, please see the JAY price list. Standard ushin 172U1 2" ushin $95.00 ushin name r part number must be filled ut w/ desired width and depth JAY undled ushin Price List 172J00 ushin Name r Part # Width: Depth: 8. POWERED SEATING Pwer Seating Optins (S Mdels) 172PJ5 E1002 Quickie SPOT HD 50 G Tilt Pwered Seating ntrl Methd (ThruDrive). $4, Pwered Seating ntrl Methd (Switch ntrl) 172EO13 E2310 Thru Drive 1 Actuatr (Fr perating Tilt thru Jystick.) $1, EO14 E2311 Thru Drive 2+ Actuatrs (2+ actuatrs per Input Device requires expandable Rnet) $2, (Fr use with pwer seating actuatrs. Switch activatin is standalne and des nt require expandable r thrudrive electrnics. 172EO10 Switch ntrl 1 actuatr w/dual tggle and munt. (Fr perating Tilt) 172EO11 Switch ntrl 1 actuatr w/buddy buttn & munt.(fr perating Tilt) 172EO12 Switch ntrl 2 3 Actuatr w/ 4way Tggle Switch & Munt. (apable f perating cmb f Tilt/Legs r legs nly) Switch Munt (fr use with switch cntrl pwered seating) 172EY01 172EY02 Switch Munt Right Switch Munt Left ORDERING INFORMATION: PHONE: (800) FA: (800) rders@sunmed.cm WESITE: Specificatins are subject t change withut ntice. pyright REV Page 4

5 9. AKREST AND AK OPTIONS ackrest Frame Type 172T8 172T98 E1225 ack Type (Uphstery r Slid) Angle Adjustable (ASAP II Seat nly) Manual Recline 40 (ASAP II Seat nly) nt width adjustable 172U1 $ U70 E2611 Tensin adj Uphlstery allistic Nyln. (with 1" width adjustment.) (Nt avail with tilt) $ U71 E2611 Tensin adj Uphlstery 3D Vented. (with 1" width adjustment) (Nt avail with tilt) $ Manual Recline Adjustment Methd Optin (ASAP II) ack Height 23". 172MN01 Tl 172MN02 Knb (NA with dual pst arms.) Angle Adjustable ackrest Optins (ASAP II) (NA with Manual recline) 172OD8 NnFlding ackrest Uphlstery (Nt avail with tilt) S.P.O.T. urved (ASAP II nly) 172U77 E2613 Jay SPO Psterir Psitining (ASAP II nly) 172U78 E U14 ART SPO ustm ack (ASAP II nly) See appendix 1 Omit Uphlstery $ See Pg 8 $15.00 Jay 3 Optin (ASAP II) ane Angle (ASAP II) 172P40 Straight ack Pst 8 end ack Pst (Avail. nly w/ Uphlstery r J3 ack) 172P41 Shallw (NA with Uphlstery backs.) 172QT04 Deep (Extends 4" frm back canes fr deep backs) (Uphlstery Height Measured pan t tp f uphlstery.) Lw (15.5") 1721 Jay J3 (select OMIT abve) See J3 OF (Limited cmbinatins f widths) Measured frm pan t tp f slid back. 172QT03 ack ane (ASAP II) ack Height Required fr SPOT urved, SPO acks. Twel ar Depth (ASAP II) 172J01 Med (17.5")1725 Tall (19.5") " " " Available n all back types. 10. HEADREST OPTIONS Available with nchair slid backs. Headrests fr Jay 3 backs need t be rdered n Jay 3 Order frm. Whitmyer Linx Headrest Small 172HE65 E MH1 $ Whitmyer Linx Headrest Large Plush Head Supprt Pad 8" 172HE66 E0955 N Tl / Quick Rem. Headrest Munt 172MH1 $ Plush Head Supprt Pad 10" N Tl / Quick Rem. Headrest Munt 11. POSTURAL SUPPORTS ALL Pstural Supprts are Sld as EAH. Must select bth left and right fr a pair. Swing Away Lateral Thracic Supprt Left Swing Away Lateral Thracic Supprt 4x5" Left Swing Away Knee Adductr Supprts 172ZV09 Lateral Pad urved 4"x5" 172ZS06 Swing Away Munt Swing Away Lateral Thracic Supprt 4x6" Left Available nly with Fixed and Pwer enter Munt Legrests. Nt available with Dual Pst Arm Rests Knee Adductr Supprts LEFT (chse Pad and Arm) $ Pad Size 172ZV11 Lateral Pad urved 4"x6" 172K5 Knee Adductr Pad SM Left 172ZS06 Swing Away Munt 172K7 Knee Adductr Pad LG Left S/A Arm Size Swing Away Lateral Thracic Supprt Right Swing Away Lateral Thracic Supprt 4x5" Right 172ZV10 Lateral Pad urved 4"x5" 172ZS05 Swing Away Munt Swing Away Shrt Left Swing Away Lng Left Knee Adductr Supprts RIGHT(chse Pad and Arm) $ Pad Size 172K6 Knee Adductr Pad SM Right 172ZV12 Lateral Pad urved 4"x6" 172K8 Knee Adductr Pad LG Right 172ZS05 Swing Away Munt Swing Away Lateral Thracic Supprt 4x6" Right Lng Thigh Supprt w/remvable Munt S/A Arm Size Swing Away Shrt Right Swing Away Lng Right Padded hest Strap Available with antilever Arms, NA with Manual Recline ack, Dual Pst, Single Pst r antilever w/ 2 pt Lcking arms. SPOT Lng Thigh Supprt Left 172TV2 Lng Thigh Supprt Left 172T1 Remvable Munt Left SPOT Lng Thigh Supprt Right 172TV1 Lng Thigh Supprt Right 172T2 Remvable Munt Right HEST STRAP 172ZR03 E0960 ORDERING INFORMATION: PHONE: (800) FA: (800) rders@sunmed.cm WESITE: Specificatins are subject t change withut ntice. pyright REV Page 5

6 12. ARMREST AND ARMPAD OPTIONS Armrest Munting fr K0850 Mdels with ASAP II Dual Pst Armrests Armrest Munting fr K0858 S Mdels with ASAP II. Dual Pst Armrests 172EG01 Shrt Dual Pst Flip ack 10" Height. 172EG09 Shrt Dual Pst Flip ack HT Adj 10"15" 172EG21 Lng Dual Pst Flip ack 10" Height. 172EG23 Lng Dual Pst Flip ack HT Adj 10"15" 172EG02 Shrt Dual Pst Flip ack HT Adj 10"15" 172EG22 Lng Dual Pst Flip ack HT Adj 10"15" antilever Armrests (Adjustable length arm pad included (chse Pad setting belw, except fr Lw Arm Optin) NA with Manual Recline ack 172EG03 172EG04 Standard antilever Arm w/ 2 Pint Lcking Pst. (9"10" Ht Range.) NA w/ seat depths belw Standard antilever Arm w/ 2 Pint Lcking Pst. (11"12" Ht Range.) NA w/ seat depths belw 172EG05 STD antilever Arm 9"12" Ht Range 172EG06 Lw antilever Arm 7"10" Ht Range (hse ASAPII pad type and size belw) Single Pst Armrests 172EG07 Single Pst Height Adjustable Std. 172EG08 Single Pst Height Adjustable Lw antilever Armrests (Adjustable length arm pad included (chse Pad setting belw, except fr Lw Arm Optin) NA with Manual Recline ack 172EG10 Standard antilever Arm w/ 2 Pint Lcking Pst. (9"10" Ht Range.) NA w/ seat depths belw 172EG11 Standard antilever Arm w/ 2 Pint Lcking Pst. (11"12" Ht Range.) NA w/ seat depths belw 172EG12 STD antilever Arm 9"12" Ht Range Lw antilever Arm 7"10" Ht Range (hse ASAPII pad type and size belw) 172EG13 Single Pst Armrests 172EG14 Single Pst Height Adjustable Std. 172EG15 Single Pst Height Adjustable Lw Omit Armrest and Munts Omit Armrest 172EG20 Armpad Optins fr ASAPII Pad Type / Size Optins fr Dual Pst / Single Pst / Lw antilever Left Arm Pad () 172AE01 Right Arm Pad () Desk Length Waterfall (10") 172A01 172AE02 Full Length Waterfall (14") NA w/lw antilever arm 172A02 172AE03 Desk Length Standard (10") 172A03 172AE04 Full Length Standard (14") NA w/lw antilever arm 172A04 Pad Setting Optins fr Standard antilever Arm Left Arm Pad () Right Arm Pad () 172AE11 Full Length antilever (14") 172A11 172AE10 Desk Length antilever (10") 172A10 ORDERING INFORMATION: PHONE: (800) FA: (800) rders@sunmed.cm WESITE: Specificatins are subject t change withut ntice. pyright REV Page 6

7 13. HANGERS AND FOOTRESTS FOR ASAP II Hanger and Extensin Tubes Optins (see ftplate cmpatibility in the brackets) NnPwered Swing Away Legrests Ftplate (Pair) Sld as Pairs A mpsite with Heel Lp (Pair) 172H95 65 Swing Away (A,) 172F1 172H2 70 Swing Away (A,) 172HL1 172H94 75 Tapered Swing Away (E) 172H6 90 Swing Away () (5.59") 172H138 E0990 Manual ELR S/A (A,,D) (Avail. with Fixed entermunt, chse belw) 172H125 K H126 E1010 entermunt Pwr ELR w/ Articulatin (F,G,H) S/A Pwer ELR w/ Articulatin () Pair (N/A fr 12" r 13" wide) (Avail. with Fixed entermunt, chse belw) $2, $2, Fixed enter Munt Legrests (includes ftplate) 172H134 Fixed enter Munt Shrt 172H135 Fixed enter Munt Lng 172xxx Fixed enter Munt Shrt 172xxx Fixed enter Munt Lng 172H144 Adult Angle Adjustable Ftplate E0951 Heel Lp Omit Hangers NOTE: Nt all extensin tube will be available; depending n the seat height, sme extensin tube ptins may nt ffer enugh grund clearance. 172F285 Adult Angle Adjustable Ftplate E0951 Heel Lp 172F283 Kids Angle Adjustable Ftplate Leg Strap 172F286 Kids Angle Adjustable Ftplate 172LS13 Leg Strap 172F287 D Aluminum (Pair) E One Piece Angle Adjust Ftplate 172F284 One piece Angle Adjustable Ftplate 172LS13 Leg Strap 172F288 F entermunt single Ftplate G entermunt dual ftplate $ F289 MT Angle Adjustable Ftplate 172HL10 E0951 Heel Lp H entermunt High Mnt Ftplate K0037 Kids Angle Adjust w/leg Strap fr use with 90 hanger(pair) 172F290 One piece Angle Adjustable Ftplate 172E16 172E1 Shrt 172E2 Medium 172E5 Lng 1725A01 E0952 Te Lp (Pair) Only avail n (pt ). 172E21 Omit Extensin 172LS14 Extra Leg Strap K0037 High Munt Hanger 172LS13 $ Kids Angle Adjust w/leg Strap fr use with 65 and 70 hanger (Pair) Hanger Extensins. (See range listed in matrix belw) 172HL10 $ Adult Angle Adjust w/heel Lp fr use with 90 hanger (Pair) Omit Hangers. 172F282 Fixed enter Munt Legrests (includes ftplate) Additinal 172HL10 Pwered Elevating Legrests Heel Lp Adult Angle Adjust w/heel Lp fr use with 65, 70 hanger and ELR (Pair) $ mpsite Ftplate 172F279 Omit Ftplate and extensin tube Ftrest Accessries Lwer Leg Length Matrix (measured seat pan t the tp f the ftplate surface) Ftplate Matrix Hanger Type High Munt Shrt Medium Lng Hanger Type A 65 Swing Away 714" " " 65 Swing Away 70 Swing Away 714" " " 70 Swing Away 75 Tapered S/A 714" Tapered S/A 90 Swing Away 5.59" Ftplate munts t frnt f hanger " Manual ELR S/A Pwer ELR S/A 1214" Pwer ELR S/A Fixed ntrmnt 12.5"15.5" " D E F G H 90 Swing Away Manual ELR S/A Pwer ntrmnt 14.5"19.5" Fixed ntrmnt " Pwer ntrmnt 14. AESSORIES Wheelchair Tray Table Psitining elt Select fr any style seat 1727A01 E0950 TRAY TALE SM TUFFAK EJ A02 E0950 TRAY TALE MED TUFFAK 1517 PWR 172EJ02 E0978 elt 2" Aircraft uckle $ A03 E0950 TRAY TALE LRG TUFFAK 1820 PWR 172EJ03 E0978 elt 2" Aircraft uckle Padded $65.00 ackpack Aut Style uckle UILT 4 ME OPTIONS 172A1 lack Utility 172A2 lack/harcal Kids $50.00 T Inquire abut any unique custmizatin fr Quickie prducts, cntact: Phne: (800) , Optin #3 r Fax: (800) ORDERING INFORMATION: PHONE: (800) FA: (800) rders@sunmed.cm WESITE: Specificatins are subject t change withut ntice. pyright REV Page 7